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Remdesivir against COVID-19 and Other Viral Diseases.
Clin Microbiol Rev. 2020 12 16; 34(1)CM

Abstract

Patients and physicians worldwide are facing tremendous health care hazards that are caused by the ongoing severe acute respiratory distress syndrome coronavirus 2 (SARS-CoV-2) pandemic. Remdesivir (GS-5734) is the first approved treatment for severe coronavirus disease 2019 (COVID-19). It is a novel nucleoside analog with a broad antiviral activity spectrum among RNA viruses, including ebolavirus (EBOV) and the respiratory pathogens Middle East respiratory syndrome coronavirus (MERS-CoV), SARS-CoV, and SARS-CoV-2. First described in 2016, the drug was derived from an antiviral library of small molecules intended to target emerging pathogenic RNA viruses. In vivo, remdesivir showed therapeutic and prophylactic effects in animal models of EBOV, MERS-CoV, SARS-CoV, and SARS-CoV-2 infection. However, the substance failed in a clinical trial on ebolavirus disease (EVD), where it was inferior to investigational monoclonal antibodies in an interim analysis. As there was no placebo control in this study, no conclusions on its efficacy in EVD can be made. In contrast, data from a placebo-controlled trial show beneficial effects for patients with COVID-19. Remdesivir reduces the time to recovery of hospitalized patients who require supplemental oxygen and may have a positive impact on mortality outcomes while having a favorable safety profile. Although this is an important milestone in the fight against COVID-19, approval of this drug will not be sufficient to solve the public health issues caused by the ongoing pandemic. Further scientific efforts are needed to evaluate the full potential of nucleoside analogs as treatment or prophylaxis of viral respiratory infections and to develop effective antivirals that are orally bioavailable.

Authors+Show Affiliations

Department I of Internal Medicine, Division of Infectious Diseases, University of Cologne, Cologne, Germany jakob.malin@uk-koeln.de. Faculty of Medicine, Center for Molecular Medicine Cologne (CMMC), University of Cologne, Cologne, Germany.Department I of Internal Medicine, Division of Infectious Diseases, University of Cologne, Cologne, Germany. German Center for Infection Research (DZIF), Partner Site Bonn-Cologne, Cologne, Germany.Department I of Internal Medicine, Division of Infectious Diseases, University of Cologne, Cologne, Germany.Department I of Internal Medicine, Division of Infectious Diseases, University of Cologne, Cologne, Germany.Department I of Internal Medicine, Division of Infectious Diseases, University of Cologne, Cologne, Germany. Faculty of Medicine, Center for Molecular Medicine Cologne (CMMC), University of Cologne, Cologne, Germany. German Center for Infection Research (DZIF), Partner Site Bonn-Cologne, Cologne, Germany.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't
Review

Language

eng

PubMed ID

33055231

Citation

Malin, Jakob J., et al. "Remdesivir Against COVID-19 and Other Viral Diseases." Clinical Microbiology Reviews, vol. 34, no. 1, 2020.
Malin JJ, Suárez I, Priesner V, et al. Remdesivir against COVID-19 and Other Viral Diseases. Clin Microbiol Rev. 2020;34(1).
Malin, J. J., Suárez, I., Priesner, V., Fätkenheuer, G., & Rybniker, J. (2020). Remdesivir against COVID-19 and Other Viral Diseases. Clinical Microbiology Reviews, 34(1). https://doi.org/10.1128/CMR.00162-20
Malin JJ, et al. Remdesivir Against COVID-19 and Other Viral Diseases. Clin Microbiol Rev. 2020 12 16;34(1) PubMed PMID: 33055231.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Remdesivir against COVID-19 and Other Viral Diseases. AU - Malin,Jakob J, AU - Suárez,Isabelle, AU - Priesner,Vanessa, AU - Fätkenheuer,Gerd, AU - Rybniker,Jan, Y1 - 2020/10/14/ PY - 2020/10/15/entrez PY - 2020/10/16/pubmed PY - 2020/10/30/medline KW - COVID-19 KW - MERS-CoV KW - SARS-CoV KW - SARS-CoV-2 KW - antiviral KW - coronavirus KW - ebolavirus KW - remdesivir JF - Clinical microbiology reviews JO - Clin Microbiol Rev VL - 34 IS - 1 N2 - Patients and physicians worldwide are facing tremendous health care hazards that are caused by the ongoing severe acute respiratory distress syndrome coronavirus 2 (SARS-CoV-2) pandemic. Remdesivir (GS-5734) is the first approved treatment for severe coronavirus disease 2019 (COVID-19). It is a novel nucleoside analog with a broad antiviral activity spectrum among RNA viruses, including ebolavirus (EBOV) and the respiratory pathogens Middle East respiratory syndrome coronavirus (MERS-CoV), SARS-CoV, and SARS-CoV-2. First described in 2016, the drug was derived from an antiviral library of small molecules intended to target emerging pathogenic RNA viruses. In vivo, remdesivir showed therapeutic and prophylactic effects in animal models of EBOV, MERS-CoV, SARS-CoV, and SARS-CoV-2 infection. However, the substance failed in a clinical trial on ebolavirus disease (EVD), where it was inferior to investigational monoclonal antibodies in an interim analysis. As there was no placebo control in this study, no conclusions on its efficacy in EVD can be made. In contrast, data from a placebo-controlled trial show beneficial effects for patients with COVID-19. Remdesivir reduces the time to recovery of hospitalized patients who require supplemental oxygen and may have a positive impact on mortality outcomes while having a favorable safety profile. Although this is an important milestone in the fight against COVID-19, approval of this drug will not be sufficient to solve the public health issues caused by the ongoing pandemic. Further scientific efforts are needed to evaluate the full potential of nucleoside analogs as treatment or prophylaxis of viral respiratory infections and to develop effective antivirals that are orally bioavailable. SN - 1098-6618 UR - https://www.unboundmedicine.com/medline/citation/33055231/Remdesivir_against_COVID_19_and_Other_Viral_Diseases_ L2 - http://cmr.asm.org/cgi/pmidlookup?view=long&pmid=33055231 DB - PRIME DP - Unbound Medicine ER -